Efficacy Of Closed Globe Refixation Of Iols Using Modified Ab-Externo Technique
Published 2025 - 43rd Congress of the ESCRS
Reference: PO270 | Type: Free paper | DOI: 10.82333/mfr4-m422
Authors: Belen Alfonso-Bartolozzi* 1 , Luis Fernández-Vega Cueto-Felgueroso 1 , Carlos Lisa 1 , David Madrid-Costa 2 , María Sagrario Millan Varela 3 , Fidel Vega Lerin 3 , José F. Alfonso 1
1Cornea & Lens,Fernandez-Vega University Institute,Oviedo,Spain, 2Optometry & Vision,Faculty of Optics & Optometry. Complutense University,Madrid,Spain, 3Optic & Optometry,Faculty of Optics & Optometry. Universitat Politècnica de Catalunya,Terrassa,Spain
Purpose
1. Assess best corrected visual outcomes following refixation of dislocated IOLs.
2. Evaluate the frequency of immediate and late postoperative complications.
3. Investigate centration and tilt of IOLs in various designs.
Setting
Consecutive patients presenting with grossly subluxated or dislocated IOLs (excluding 3-piece lenses) were included.
Methods
9-0 polypropylene or Gortex sutures anchored dislocated IOLs using a modified ab-externo technique. Sutures were passed/looped/pierced through dialing holes, eyelets, dual loops, or haptic-optic junctions and secured to the sclera. Postoperative IOL centration and tilt were imaged using CASIA-1 anterior segment OCT.
Results
Among 37 refixed eyes, mean preoperative BCVA was 0.42 logMAR (35 eyes) and 1.9 logMAR units (2 eyes). Postoperative BCVA improved to 0.3 logMAR units (35 eyes). Mean IOL centration was 0.437 microns, and tilt was 4.23 degrees (29 eyes). Three eyes experienced transient vitreous hemorrhage, one required revision surgery, and another required gas tamponade for macular hole development.
Conclusions
Closed globe refixation of IOLs using a modified ab-externo technique is safe and effective, with acceptable centration and tilt. This minimally invasive technique preserves the original IOL, allowing for rapid recovery.